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ABSTRACT BACKGROUND. A 7-year-old previously healthy girl was injured in a traffic accident and presented to the emergency room with abdominal pain, microscopic hematuria, and wide skin

defects and deep lacerations on the left flank, left upper abdomen, and right inguinal area. Initial CT of the abdomen was unremarkable. 3 weeks later, the patient complained of abdominal

distension, left flank pain, and fever. INVESTIGATIONS. Blood and urine tests, CT of the abdomen, chest X-ray, antegrade pyelography, intravenous urography, renal ultrasonography and

diuretic renal scan. DIAGNOSIS. Complete avulsion injury of the left ureteropelvic junction MANAGEMENT. The patient underwent 11 plastic reconstructive surgeries, including a skin grafting

operation. A percutaneous nephrostomy was performed for temporary diversion. After complete healing of the left flank wound, open pyeloplasty was performed to create a ureteropelvic

anastomosis with stent. The patient was discharged 1 week after surgery and the stent was removed 5 weeks later. 5 years after pyeloplasty, her renal function was normal and she had

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our FAQs * Contact customer support REFERENCES * Reznichek, R. C., Brosman, S. A. & Rhodes, D. B. Ureteral avulsion from blunt trauma. _J. Urol._ 109, 812–816 (1973). Article  CAS 

Google Scholar  * Zufall, R. Traumatic avulsion of the upper ureter. _J. Urol._ 85, 246–248 (1961). Article  CAS  Google Scholar  * Forbes, C. D., Craig, J. A., Prentice, C. R. M. &

Sutherland, R. Rupture of the ureter due to crushing injury in a boy with severe hemophilia. _Br. J. Surg._ 58, 931–934 (1971). Article  CAS  Google Scholar  * Boone, T. B., Gilling, P. J.

& Husmann, D. A. Uretero pelvic junction disruption following blunt abdominal trauma. _J. Urol._ 150, 33–36 (1993). Article  CAS  Google Scholar  * Al-Jasser, A. & Onoura, V. C.

Delayed bilateral uretero pelvic junction obstruction from blunt trauma. _Ann. Saudi Med._ 12, 403–405 (1992). Article  CAS  Google Scholar  * Boston, V. E. & Smyth, B. T. Bilateral

pelvi-ureteric avulsion following closed trauma. _Br. J. Urol._ 47, 149–151 (1975). Article  CAS  Google Scholar  * Bartley, O., Ekdahl, P. H. & Wahlqvist, L. Rupture of the ureter with

pseudocyst formation. _Acta Chirurg. Scand._ 132, 390–396 (1966). CAS  Google Scholar  * Kawashima, A., Sandler, C. M., Corriere, J. N., Rodgers, B. M. & Goldman, S. M. Ureteropelvic

junction injuries secondary to blunt abdominal trauma. _Radiology_ 205, 487–492 (1997). Article  CAS  Google Scholar  * White, M. A., Kepros, J. P. & Zuckerman, L. J. Bilateral partial

ureteropelvic junction disruption after blunt trauma treated with indwelling ureteral stents. _Urology_ 69, 384.e15–e17 (2007). Article  Google Scholar  * Mulligan, J. M., Cagiannos, J.,

Collins, J. P. & Millward, S. F. Ureteropelvic junction disruption secondary to blunt trauma: excretory phase imaging (delayed films) should help prevent a missed diagnosis. _J. Urol._

159, 67–70 (1998). Article  CAS  Google Scholar  * McGinty, D. M. & Mendez, R. Traumatic ureteral injuries with delayed recognition. _Urology_ 10, 115–117 (1977). Article  CAS  Google

Scholar  * Kattan, S. Traumatic pelvi-ureteric junction disruption. How can we avoid delayed diagnosis? _Injury_ 32, 797–800 (2001). Article  CAS  Google Scholar  * Cass, A. S. Immediate

radiological evaluation and early surgical management of genitourinary injuries from external trauma. _J Urol._ 122, 772–774 (1979). Article  CAS  Google Scholar  * Morey, A. F., McAninch,

J. W., Tiller, B. K., Duckett, C. P. & Carroll, P. R. Single shot intraoperative excretory urography for the immediate evaluation of renal trauma. _J. Urol._ 161, 1088–1092 (1999).

Article  CAS  Google Scholar  * Carlton, C. E., Scott, R. & Guthrie, A. G. The initial management of ureteral injuries: a report of 78 cases. _J. Urol._ 105, 335–340 (1971). Article 

Google Scholar  * Steer, W. D., Carriere, J. N., Benson, G. S. & Boileau, M. A. The use of indwelling ureteral stents in managing ureteral injuries due to external violence. _J. Trauma_

25, 1001–1003 (1985). Article  Google Scholar  Download references ACKNOWLEDGEMENTS This work was supported for 2 years by Pusan National University Research Grant. AUTHOR INFORMATION

AUTHORS AND AFFILIATIONS * Department of Urology, Kosin University College of Medicine, Busan, Korea Jae Min Chung * Department of Pediatrics and Adolescent Medicine, Pusan National

University School of Medicine, Yangsan, Korea Su Yung Kim * Department of Urology, Pusan National University School of Medicine, Yangsan, Korea Sang Don Lee Authors * Jae Min Chung View

author publications You can also search for this author inPubMed Google Scholar * Su Yung Kim View author publications You can also search for this author inPubMed Google Scholar * Sang Don

Lee View author publications You can also search for this author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to Sang Don Lee. ETHICS DECLARATIONS COMPETING INTERESTS The

authors declare no competing financial interests. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Chung, J., Kim, S. & Lee, S. Delayed diagnosis of

ureteropelvic junction avulsion in a child owing to unstable hemodynamics. _Nat Rev Urol_ 6, 509–512 (2009). https://doi.org/10.1038/nrurol.2009.148 Download citation * Issue Date: September

2009 * DOI: https://doi.org/10.1038/nrurol.2009.148 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link

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